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Children’s Pain Undertreated in the Emergency Room

Imagine having to take your child to the emergency room for a broken leg or flare-up of a more serious, painful condition like juvenile rheumatoid arthritis or sickle cell disease, and no one bothers to offer any pain relief. That situation is all too common.

You know how bad you feel when your child has an earache or a good scrape on the knee—you’ll do anything to ease the discomfort (hello, ice cream!). Imagine having to take her to the emergency room for a broken leg or flare-up of a more serious, painful condition like juvenile rheumatoid arthritis or sickle cell disease, and no one bothers to offer any pain relief. That situation is all too common, and has prompted the American Academy of Pediatrics to issue a new clinical report “Relief of Pain and Anxiety in Pediatric Patients in Emergency Medical Systems,” published today in today’s issue of Pediatrics. Co-author Joel A. Fein, M.D., professor of pediatrics and emergency medicine at the University of Pennsylvania and attending emergency room physician at the Children’s Hospital of Philadelphia, led a team that analyzed how best to safely make these young, scared, and hurting patients more comfortable.

Inadequate pain relief happens for a variety of understandable reasons when it comes to pediatric patients—uncertainty about how much pain a child is in, fear of medication side effects like impaired breathing, staffing and time constraints, and unfamiliarity with new pain relief products. Parents, too, might rightly be afraid of allowing their children to receive high-powered pain medications. The new report aims to overcome those obstacles with guidelines and training recommendations for ER physicians as well as EMS personnel who may begin treatment in an emergency situation before the child arrives at the hospital. It’s not always about an IV or strong narcotic: In many cases, something as simple as a dose of ibuprofen and a coloring book to keep the child busy will do the trick.

The study authors also encourage parents to be proactive about when it comes to their children’s needs in an emergency room. On a busy day, a broken leg may not seem like such a big deal to the staff, so speak up to ensure that your child is made comfortable.